A baby monitor that ‘socks’ it to you

owlet-1211-40Students at Brigham Young University in Utah have developed a prototype ‘smart sock’ for babies that alerts for low levels of blood oxygen, irregular heartbeat and stopped breathing during sleep. This is to help detect for early signs of SIDS (Sudden Infant Death Syndrome) or other dangerous situations. The information is sent to a smartphone app that serves as the alert monitor. The Owlet Baby Monitor won first place and crowd favorite awards, with cash prizes totaling $6,000, at the Student Innovator of the Year competition. The inventors have filed for a patent (pending), more prototypes and testing, and undoubtedly FDA, but if you’re an angel looking for a highly marketable telehealth item–and with adult uses in hospitals and nursing homes–a trip to Utah may be in order. “Smart Socks” Helps Parents Sleep Easier (Smart Phone Healthcare) BYU news release (video)

Crain’s Health Tech Summit (NYC)

In general, systems coped and helped others out which were flooded or lost power; NS-LIJ took in patients from evacuated NY Health and Hospitals Corporation (NYHHC) facilities as well as NYU-Langone Medical Center. In opening remarks, NS-LIJ CEO Michael Dowling pointed out the large gap that had to be worked around–a torrent of new admissions, and being unable to access non-network EHRs. He also pointed out that what healthcare needs is the right data to make the right decisions, and that health care systems were liable to data overload–too much, not right and thus not actionable. Closing remarks by HHC’s CEO Alan Aviles returned to Sandy and were a blow-by-blow account of hospital disaster response, followed by what was being done (step by step) to restore services and lessons for the future.

Dan Cerutti of IBM’s Watson commercialization area presented the development of Watson’s deep Q/A in processing structured and unstructured data, and their tackling oncology first in partnership with WellPoint, and refining the decision making model through research with the Cleveland Clinic. [More in TA 27 Sept and 1 Nov] WellPoint’s CTO Rickey Tang extended the discussion into the wild and wooly world of utilization management, so dear to payers and so badly in need of streamlining in precertification, collection of missing information, cost transparency and post-service review. Both Watson and WellPoint are intent on redoing the UM process; eHealth developers should especially keep an eye on how this restructuring develops. A rather surprising factoid tossed out by Mr. Tang was that 81% of doctors spend less than 5 hours/month reading journals, which gave your Editor pause, especially with state and specialty continuing education requirements; does this account for how physicians are transitioning to consuming information via PCs and mobiles?

The Payers and Providers: Making Health Tech Work panel again returned to how to utilize data in moving to evidence-based care, and then moved forward into issues such as connectivity and patient engagement–extending care to the life of the patient outside the walls of the hospital and the doctor’s office. Managing massive amounts of data into workflow was also a major concern of the panel. Charles Saunders, M.D. of Aetna Emerging Businesses noted the fine line between Big Data and Big Brother. Aetna is developing a payer-neutral infrastructure with providers through Accountable Care Solutions to narrow population gaps in care and integrating its patient engagement application, iTriage [TA 24 Dec 2011], to fill what he termed the ‘white space’ between visits. In later remarks, he added case management and call centers to that mix; in total, more overlap, not less, between provider and payer. For providers, their approach is also affected by the composition of their patient population. Pamela Brier, CEO of Brooklyn’s Maimonides Medical Center, pointed out the special challenges of being both the largest Medicaid provider in the borough–now moving to a managed care vs. fee-for-service model–and having a major commitment to the seriously mentally ill, which are for now both roadblocks for Maimonides moving into an accountable care (ACO) model. Their focus is on the electronic transfer and integration of patient information between providers through the local RHIO (regional health information organization). Dr. Neil Calman of the Institute of Family Health and the Mount Sinai School of Medicine, from the primary care provider view, proposed that useful data is real time, alerting to patient status and responding to patients at the ER (ED), and will inevitably result in workflow changes. Marco Diaz, representing employers as VP Benefits for Thomson Reuters, thought the balance would come at the consumer level, in matching and integrating individual data, engagement and actions into records. In follow up questions from the floor, panelists were asked about their experiences with remote patient monitoring (telehealth) integration and the effect on same-cause readmissions. Ms. Brier’s experience has been about a 15% reduction, with a key factor the integration of care managers; Dr. Saunders claimed that the rate could be as high as 40% if transitions of care are managed effectively. A sobering note at the end concerned data tracking and a potential increase in liability, not only from the data capture but also from data breaches. However, Dr. Calman positioned this as more importantly, and inevitably, a manageable risk in an improved standard of care, with RHIOs and an ‘electronic trail’ being part of the security solution.

 

After a break, the shorter Innovations and the Market panel discussed what can be successful–and not–in health tech. David Blumenthal, M.D. of Partners Healthcare, which is heavily involved in innovative telehealth such as text reminders and startups such as Healthrageous [TA 17 Oct], told a cautionary tale about his encounter with a ‘Silicon Valley hotshot’ who thought his app was ‘the end’–it was, though not in the sense he intended. What is obvious to the developer is not necessarily that to the consumer. Patients don’t listen! Medivo, an early-stage monitoring/lab result tracking company founded by seasoned veteran Sundeep Bhan, has evolved its revenue model several times as it has grown. To Maria Gotsch, CEO of the NYC Investment Fund, the real revolution is coming with data analysis and the tools to make it actionable. Similar tools have been pioneered in the financial sector, and NY is rich in skilled people. However, the talent hasn’t yet migrated from financial to health tech–the VC mentality is still stuck in financial and shopping websites–but the outlook is improving. The panel agreed that for healthcare innovations, ROI in the traditional sense remains problematic, but is rapidly becoming part of a new standard of care delivery.

 

Tweetstream at #crainshealth.  Many thanks to Crain’s event producer Courtney Williams for facilitating Editor Donna’s attendance.


Update 19 Nov: North Shore-LIJ–a healthcare behemoth in the making? Crain’s seems to think so here.

 

Telehealth Soapbox: When the elephant in the room has no smartphone

Carolyn Thomas, a Canadian writer, Mayo Clinic-trained advocate for women’s heart health and herself a heart attack survivor, observes the parade of self-monitoring and Quantified Selfing by ‘urban datasexuals’ at Stanford University’s Medicine X conference at end of September. Originally published in her blog Heart Sisters.

stanford med x conference centreShortly after arriving at Stanford University School of Medicine to attend the conference called Medicine X (“at the intersection of medicine and emerging technologies”), it hit me that I didn’t quite belong there. Maybe, I wondered, the conference organizers (like the profoundly amazing Dr. Larry Chu) may have goofed by awarding me an “ePatient Scholarship” – rather than a more tech-savvy, wired and younger patient in my stead.

Please don’t get me wrong – I was and still am duly thrilled and humbled to be chosen as one of 30 participants invited to attend MedX as ePatient scholars, generously funded by Alliance Health after we met selection criteria like “a history of patient engagement, community outreach and advocacy”.

But almost immediately, I started feeling like a bit of a fraud… (more…)

Health 2.0 NYC: Pitch Yourself Into the ‘Shark Tank’

with Philippe Chambon of New Leaf Venture Partners. Other panelists included fellow entrepreneur Brett Shamosh of Wellapps (purchased by Medivo), Milena Adamian, MD of Life Science Angel Network, Esther Dyson of EDVenture, Donna Usiskin of a private investment team, and Alan Brody of the iBreakfast start-up forum.

Both the winner and runner-up were considered by the panel and audience to be ‘contendahs’:

The winner was not related to telehealth at all–BriteSeed’s SafeSnips technology is a near-infrared sensor which can detect blood vessels’ location, diameter size and blood flow, preventing catastrophic cutting into same during minimally invasive or robotic surgeries. This risk is estimated at 2.9% of these surgeries and SafeSnips would help surgeons avoid this at an average cost of $200/surgery. The technology was originally developed out of Northwestern University and they have an outstanding advisory board. And they already have a strong marketing tag: ‘SafeSnips puts the sense into surgical tools’. Congratulations to founder Paul Fehrenbacher on an excellent presentation which smartly included some rather graphic (to non-clinicals) surgical video to drive home the ‘catastrophic’ point. (Pictures do tell the ‘pain point’.) Editor Donna’s neighbor’s consensus was this was a high risk venture (with FDA approval and patent still pending)–but also high potential reward.

The runner-up is of interest to our readers who are concerned with older adults and their living arrangements, especially when that person can no longer live at home safely or needs a higher level of special assistance in everyday care, such as what we in the US call ‘memory care’. Silver Living is effectively a TripAdvisor(R) for senior communities. It independently reviews communities on factors such as care, appearance (independent photos), geography, residence availability, pricing, independent family and resident reviews, and state inspection reports. It also enables users (primarily younger family members) to compare communities much like an Edmunds.com does with cars. In the US, senior communities are a $200 billion market, but with a 46% turnover and onsite sales only; family members often cannot conveniently visit or compare desired communities, as they may live at a distance from the older adult at what is often a painful and emotional time. Bookings could be made directly on the site. Silver Living would also be a useful tool for hospital discharge planners, geriatric care managers, home care managers, doctors and social workers who generally do not have complete or updated referral resources. The revenue model is based on resident referrals (a potential limitation) but with the market size and need…the audience consensus was, ‘why hasn’t someone thought of this before?’ Congratulations to founder Tal Ziv on a strong and detailed presentation

The other presenters were Health2Social (patient empowerment using social media), Health Options Worldwide (automating care and treatment options for companies’ high cost patients) and Talk About Health (a platform for cancer questions, answers and support). All great ideas and developing in the heart of NYC, which is slowly but surely becoming friendler (albeit expensive) territory for healthcare-related startups.

Video will shortly be available on this link. Many thanks to the organizers, especially Alex Fair of FairCareMD and the first healthcare crowdfunder MedStartr. (TA 12 July; more on this to follow) and Steve Greene of Sperlingreene.

All the telehealth you need, ‘in’ your phone

phone-sensorsIf the Lifewatch V does what it claims to do, hubs and connected devices may be on their way to obsolescence.  Using sensors on and apps in an Android-based smartphone, it measures ECG (one lead), body temperature, blood glucose, heart rate, oxygen saturation, body fat percentage and stress levels (heart rate variability), delivering the test results to a cloud-based server accessible for analysis and sending to the monitoring physician or clinician. For blood glucose, your strips are actually inserted into the phone.  There’s also a med reminder, a pedometer application, diet plans and logs for exercise and weight.  Whew!  The company is based in Israel and is actively seeking partners for launch into markets.  Gizmodo calls it the smartphone that could save your life.  Oh yes, it alerts a call center–and you can make phone calls, text and email too.  Not FDA approved as of yet, but it is definitely in the whiz-bang category.  Hat tip to one of our readers (at his request, anonymous.)

What I learned at Health 2.0 NYC

  • Rip Road and text connectivity’s appeal. This is the firm responsible for Mount Sinai’s ‘Text in the City’ adolescent health and Partners HealthCare prenatal text programs. Texting not only has great relevance to a younger group, but has appeal that cuts across all ages, demographics and phone types, is HIPAA compliant and not a budget buster. President and founder Eric Leven’s strong presentation begged the question–why aren’t more providers doing this right now? Or are we in the field so in love with smartphones that texting ain’t cool enough to use right now?
  • ClickCare and doctor/clinician/patient connectivity. This is a platform (mobile and desktop) started in 1995 by two doctors which essentially is a virtual doctors’ lounge where physicians can easily collaborate on patient results and share images. It also permits other clinicians and (in a limited fashion) patients and families to see information. Business model is a $99/month per license subscription. Business Development VP Angela Speziale presented.
  • Perhaps most important in potential to telehealth providers is the overlooked concept of ‘transitional care’. Amaji’s Ben Spivey described the critical inflection point where the patient is being discharged from the hospital on ‘the bubble’ as requiring more than traditional home care–the need is in-home primary care. This comprises in-home visits (usually by mid-level providers) who manage rather than simply monitor patients; coordinated home visits and ancillary services such as routine outpatient visits, home nursing and home telemonitoring services, enabled by Amaji’s fully interoperable EMR. Here is a role for technology combined with care management and provider support. And some eHealth providers are now getting it. Honeywell HomMed, which many of us know as strictly a hardware provider–its latest being Genesis Touch–has combined services like Amaji, Ascend HIT and Verizon Wireless into LifeStream Partners.

 

Other presenters were Spain’s Kanteron Systems (open source digital imaging, including 3D imaging superimposed on the body prior to surgery); Fluent Medical (gaps in clinic workflow, CancerLife (patient support online network) and Fresh Digital (in hospital patient education).

 

Finally, Health 2.0 NYC head organizer Alex Fair is moving forward a ‘kickstarter’ for early-stage funding in eHealth…more on this when it happens!

Telecare Soapbox: Is mHealth/eHealth becoming a ‘Field of Dreams’?

Editor Donna muses on the link in the telecare chain where it can all fall down – the person who is expected to use the device.

“If you build it, they will come”–misattributed to the film Field of Dreams, 1989

We can get telehealth and mhealth into the home care or healthcare provider, payer, ‘app store’ or ‘ecosystem’ (the ‘push’), but you cannot force the client or patient to use it.

The buzz may be about how slick a system or app is, how to sell it to the C-suite or even the Four Big Questions, but have we forgotten someone? We assume that end users/clients/patients will be delighted to use our wonderful devices, in the way they should be used–consistently, correctly, continuously until they… expire. Step back and think about human behavior, however, and you realize…that cannot be true. (more…)

Connected Health Symposium 2011: reviews and recaps

We’ll reserve this space for various articles, blog postings, Tweetstreams and insights about the Connected Health Symposium, held 20-21 October, sponsored by the Center for Connected Health. With regrets once again, Ed. Donna was otherwise engaged and was unable to take that not-too-long train ride north. Your comments/reflections invited.

Connected Health Symposium looks for answers to healthcare’s troubling questions. HealthcareITNews

The official CHS Tweetstream (#chs11)

Dr. Joseph Kvedar’s cHealth Blog on the MIT Media Lab presence at CHS, representing the objective assessment of patient via reactions to emotional stimuli, ‘affective computing’, and the role of ‘relational agents‘ (who can help to deliver healthcare).

From the HIT perspective, Melody Smith Jones attending from the Perficient technology consulting firm on Meeting patients halfway reduces costs. “Everyone is discussing ways to best engage patients and, not surprisingly, what the price tag of such ambitious efforts will amount to.”

Connected Health Symposium offers pitfalls and possibilities for wireless innovation. MobileHealthWatch reports that there was an emphasis on low-cost innovations in wireless health, specifically “pilot projects that look really great at conferences but that no one ever uses,” as well as projects that look great when they’re launched, then die out when the money runs out.”

Telecare Soapbox: Telehealth for the intellectually disabled

About the author: Andrea Swayne is a gerontologist who received her M.A. from Bethel University (Minnesota). She possesses 25 years of experience serving seniors at all levels of the care continuum. Starting with a B.A. in music therapy from Western Illinois University, Andrea worked with the intellectually disabled along with many other populations in need. She first became familiar with telehealth while piloting remote sensor-based behavioral monitoring in the early 2000’s for Volunteers of America. Currently, Andrea is a Director of Partner Services for WellAWARE Systems, which proactively identifies variations in key wellness indicators such as sleep quality, bathroom usage and activity level.

In our short history, telehealth has primarily concentrated efforts on individuals who are aged and who are attempting to remain as independent as possible for as long as possible in their least restrictive environments. Least restrictive environments for the aged include (but are not limited to) assisted living facilities, independent living apartments or the client’s primary residence with services provided by a home health agency.

I believe that another population could significantly benefit from telehealth: the intellectually disabled (ID). (more…)

Health 2.0 NYC: Healthcare Kickstarter

Health 2.0 NYC, Healthcare Kickstarter

New York, NYU Stern 17 August 2011

Your reporter: Donna Cusano

Ed. Donna attended this three-hour event which was a ‘reverse pitch’-eight New York City-based early-stage financing people (and one provider/corporate venture) presented to an audience of nearly 200, including representatives of 80 startups. They represented an interesting cross-section of assistance and funding.

 

The ‘Connector’

StartupHealth

Presenters: co-founders Steve Krein and Unity Stoakes

A connector-type or collaborative organization which is intended to create an ‘ecosystem’ for healthcare startups, and designed to improve access to capital, education and resources for health and wellness entrepreneurs. It originated as part of the White House’s current (June) entrepreneurial support effort called Startup America Partnership. As presented in the meeting, their goal is to create a campus for healthcare entrepreneurs in NYC to shepherd companies through the idea, startup, rampup and speedup phases of development past the traps of expertise, services, talent, customers and capital. Steve and Unity are also co-founders of OrganizedWisdom which enables doctors to set up a web presences ‘in minutes’.

 

The VC

Milestone Venture Partners

Todd Pietri, co-founder

Milestone Venture Partners is a digital health investor group which currently manages 13 companies in healthcare with about a $25 million investment, but specifically avoids therapeutic devices. Their investments include MedPageToday (sold), dLife (diabetes management), Medidata and GenomeQuest.

 

The Challenge

Health 2.0 Challenge

Jean-Luc (JL) Neptune, Director

This offshoot of Health 2.0 is all about ‘problem solving for a prize’-coding, applications-for specific sponsors.

 

The Angel

Life Sciences Angel Network (LSAN)

Milena Adamian, MD, PhD, Director

 

This offshoot of the New York Academy of Sciences started nine months ago and claims to be the first angel group in NYC investing in life sciences. In a relatively short, 9 months of existence, they have already funded 3 companies and there are at least 3 strong candidates until the end of this year. It fills the gap between Technology Transfer Offices and venture funding, and also educates entrepreneurs and investors.

 

The Corporate Venture

Visiting Nurse Service of NY (VNSNY)

Michael Monson, SVP Performance and Innovation

VNSNY is in the unusual position of being both a payer (Medicare Advantage) and a service provider in long-term care. His major points to developers:

  • any device or service MUST fit into clinical workflow, doesn’t depend on changing consumer behavior and ideally should be disposable!
  • especially do not make it dependent on a smartphone which requires a level of dexterity and visual acuity that many older people simply do not possess.

However, in seeming contradiction of above, Mike is especially interested in systems which can positively impact individual behavior, especially in compliance, disease management and in workflow productivity.

 

The Mentor

Blueprint Health

Matt Farkash, Founding Partner

Blueprint Health is a NYC-based startup accelerator that will be offering (January 2012) an intensive three-month program to NY-based entrepreneurs. It provides $20,000 of seed capital, extensive mentorship and a shared work environment to help entrepreneurs go from idea to prototype and provide access to angel and venture capital investors. Already 65 mentors-VCs, payers, providers-are affiliated.

 

The Incubator

NYU Innovation Venture Fund

Frank Rimalovski, Managing Director

The NYU Innovation Venture Fund is a seed-stage ($100K level) venture capital fund created to invest in startups built upon NYU technologies and intellectual property. It helps in developing product commercialization and patentable inventions.

 

The burning questions:

1) How do entrepreneurs get investors’ attention?

  • Referrals-or a 1-2 line pitch in a highly targeted email. Know the bios of the principals and the portfolio to get the fit, and figure out a connection (Pietri)
  • Develop a kicka** product where people pay you (JL Neptune)
  • Solve a real world problem (Monson)
  • Partnership plays with insurance companies (payers)
  • Understand that this is not a friendly process (Krein)
  • Confidentiality, at least prior to investment, is impossible (Pietri)
  • Overall, there’s a problem in backing of NYC-based healthcare startups (although online doctor appointment scheduler ZocDoc got another $50 million in Series C funding from Russian billionaire Yuri Milner’s DST Global earlier this month.)

2) How do entrepreneurs deal with providers who are ‘stuck in the mud’? These are especially hospitals but can be doctors, payers.

  • Put together a ‘dream team’-people with expertise in business, tech and a designer (Krein)
  • Understand that for providers, ‘improving outcomes’ is not that desirable of a benefit (!). For payers, it is a big plus (e.g. WellDoc’s Diabetes Manager) (Monson)
  • The changes in healthcare delivery are slow in coming

3) Opportunities-and not

There is an opportunity to build a model for integrated health (Monson)

  • A favorable model would concentrate on data and software, have a recurring revenue model and show distinct signs of acceleration (Pietri)
  • Delivering a lower cost model
  • Not favored-media businesses, EHRs (all)

 

Video on Livestream, multiple clips (wait a bit to get the videos to play after the interminable commercials)

Many thanks to Health 2.0 NYC organizer Alex Fair (FairCareMD, which allows consumers to shop openly for healthcare pricing and matches patients and providers) and the sponsors for hosting!

 

 

MHX 2011 Conference Report

A highlights report on Day 2 of the recent Mobile Health Expo (MHX) 2011 in NYC. Some points:

  • mHealth as the convergence of social media (SM) and healthcare (HC) or wellness care (WC)
  • 7,000–or 2%–of Apple AppStore apps are clinically related
  • Need safeguards for such mHealth apps as diabetic insulin dose calculators;  doctors very wary due to risk and liability, not to mention significant implications for HIPAA privacy and security
  • social support a key motivator

Many thanks to reader Bill Oravecz of EHR and health management consultancy WTO Associates.  Report

The ATA 2011 virtual conference report

While New York-based Ed. Donna were not in Tampa for ATA 2011, Eds. Donna and Steve kept up with conference news from various sources and Tweetstreams galore. Starting Friday/Saturday with pre-show news, this area will be updated continuously starting Monday through end of week. Most recent information will be first.

**Updated 6 May**

Friday 6 May: Editor, Donna Cusano

  • The next generation of telehealth cometh–or RIP, Intel Health Guide PHS6000: Raising some surprise on the ATA show floor was the demise of intel-health-guide-blood-pressure-monitoringone of the pioneers–the stand-alone Intel Health Guide PHS6000 which Intel formally introduced in 2008 after testing since 2005. Intel-GE Care Innovations representatives told our sources that sales of the ‘white box’ were concluded and current installations would be transitioning over to the PC platform, now called the Intel-GE Care Innovations Guide, no longer the ‘Health Guide Express’ of only two months ago [TA 5 Mar]. The 2 May release plumps the new Guide as ‘commercially available’ without mentioning any of this of course, along with the first customer, Virtual Health, a new concierge-style health and wellness service provider for a dual audience–seniors and new mothers–which will deploy it starting in May. Confirming that the PHS6000 is moving into the history books is the device’s absence from the ‘Intel Health Guide’ tab on the website and the depiction of the Care Innovations Guide–although the scrubbing is incomplete, as the PHS6000 lives on in the tech specs and a solution brief. It’s another indicator that the technology is moving on to different and more usable forms, even though the (paying) markets are still scarce on the ground. And the other early ’00s pioneer in their stable–GE QuietCare–if and when will be their next gen?

More information on the CI Guide from the release: it’s platformed on Windows 7, requires an SD card slot and webcam, and is available on notebooks, tablets, netbooks, desktops, and all-in-one devices, preferably with a touch screen. Connectivity is to specific models of peripheral medical devices such as weight scales, blood pressure monitors etc. Also mentioned is synchronization of their data with ‘existing IT infrastructure’ but not specifically EHRs.

  • Where’s Waldo (Health)? For their second ATA and ready to market with the 510(k) in hand, Waldo Health is adding ECG to its peripherals connecting to its touchscreen PC-type monitor –a combination of a Zephyr heart rate belt with Monebo cardiac ECG software. It is probably a first in telehealth and certainly in the portable monitor type–and with a big benefit: reading and recording discrepancies in the heart scan which are even earlier indicators of congestive heart failure (CHF), before the telltale weight gain or breathing difficulties that presage greater trouble. Our source visiting their booth had his ‘socks blown off’ by this. Press announcement scheduled later this month. Hat tip to reader John Boden of ElderIssues.
  • Cisco’s telehealth head Kaveh Safavi on the possibilities, challenges and opportunities for telehealth: replacing and doing more of what you do today, plus things you couldn’t even think of. Destination ATA.
  • Scottish Development International (SDI) had a major presence on the ATA floor, marketing the research power of their universities like GCU plus their success stories with companies like Celestor, Mobile Health Care Networks, Emotional Sciences, Robomotics and Antara Consulting. The enthusiasm of their representatives really comes through on their seven videos from the show floor on SDI’s YouTube channel (right up there with David Pogue); nevertheless some American viewers may feel the need for subtitles.
  • Who pays (one of our Four Big Questions)…remains difficult. There may be some opportunities in the ‘reform’ Federal legislation, in HITECH with the Beacon Community Program, and California is looking into updating its 1996 bill to include current practice (’bout time, dudes!). While 34 other states have some Medicaid reimbursement, it is so restrictive it hardly makes sense for providers to attempt it. ACOs and Medicaid Health Homes may be other options but certainly not cure-alls. At ATA show, telemedicine reimbursement takes center stage Search HealthIT
  • And wrapping up…Destination ATA show floor video (05:38): Referenced by Ed. Steve below. Companies featured are MedVision, SDI, MinXRay, VoCare, VGo and concluding with a steel band for a festive finish.

Thursday 5 May: Editor, Steve Hards

Some more videos from the conference, courtesy of Healthcare IT News in addition to the Martin Cooper/David Pogue one and the Exhibit Hall Highlights referenced by Donna previously. For a bit of levity, readers may also want to see ‘David Pogue wants an iPhone’.

Tuesday 3 May: Editor, Donna Cusano

  • More on Bosch Healthcare’s enhanced clinical web application for care management which is being previewed at ATA. The new platform has been in use in Europe and the UK for the past year, and integrates data from both Health Buddy and the ViTelCare T400 in greater depth and detail than is currently featured. According to Skip Coleman, Bosch’s Account and Implementation manager, it is designed for ease of use by care managers, administrators, nurses and physicians who can selectively look at individuals and populations as needed; the architecture will also permit expansion to mobile. The plan is for current US Health Buddy and ViTelCare clients to migrate to the new platform by end of year. Thanks to Skip, Melanie Fagen of Bosch’s marketing department and Julie Zappelli of GCI.
  • Vidyo, the Hackensack, New Jersey video conferencing company, and American Well announced their agreement to incorporate Vidyo’s HD communications platform into American Well’s Online Care Suite for video/audio physician-patient consults. American Well taps Vidyo for enhanced video conferencing, Destination ATA. Prior to ATA, Boston-based Partners Healthcare announced they were upgrading its current telestroke program to Vidyo’s platform to create a more mobile, secure network that allows doctors to consult with patients and community hospitals far more flexibly–from the exam room, a computer at home, or a mobile application on the go, as long as they have a webcam and a basic internet connection. And patients would pay out of pocket for the service. Boston Globe
  • On Monday, University of Pittsburgh Medical Center (UPMC) announced that they have named Alcatel-Lucent (plus their Bell Labs subsidiary) to create a single platform for all its 16 telemedicine service lines, including a secure web portal from which patients can access scheduled and emergency care through a number of mobile devices, using real-time audio and video. Destination ATA
  • CMS announced a final rule streamlining physician credentialing for telemedicine. The hospital receiving the telemedicine services “may rely upon” information provided by the consulting hospital when making privileging decisions for physicians offering the consultations. Health Data Management
  • InTouch Health premiered the RP-Xpress, a portable telemedicine device using standard 802.11 Wi-Fi for video consults in clinical environments. Release.

Monday 2 May: Editor, Donna Cusano

  • At the Sunday afternoon plenary:
    • ATA’s president Dale Alverson, M.D. called current conditions the ‘perfect storm’ for telemedicine and the transformation of healthcare delivery. Factors: economic downturn, aging population, the critical shortage of healthcare providers. Health information and new technologies will facilitate transformation and get us through these challenges. ‘Health diplomacy’ is needed: “We need to work together. And the reason we need to do that is that most health issues are global. And we can share knowledge and information in meaningful ways that you couldn’t before.”
    • **Updated 6 May** Jitterbug founder and inventor of the modern mobile phone circa 1972, the legendary Dr. Martin Cooper was interviewed by New York Times personal technology columnist (songwriter, keyboardist and singer) David Pogue. Dr. Cooper’s future vision lies in “personalization and customization” around how individuals prefer to use their devices. See an original Motorola StarTac (a/k/a The Brick) Video. (04:25) Mobihealthnews‘ interview with Dr. Cooper, focusing on mobile health, is notable for two quotes:
      • Health apps are superficial and incomplete. It’s so easy to come up with an app that attacks the surface or the easy stuff. To create something that people will really use is hard.”
      • “People think of technology as being science and engineering, but technology doesn’t mean anything if it doesn’t involve people. Technology is the application of science to create products, services, and devices that make people’s lives better. You can’t separate the two.”
    • ATA’s annual awards presented to Dena Puskin, ScD of HHS, Hubble Telemedical, Michael D. Abramoff, MD, PhD, Alice Borrelli of Intel, University of Arkansas for Medical Science,and the ATA Telehealth Nursing SIG. The 2011 ATA College of Fellows were inducted. At opening plenary, ATA speakers tout growth and change, Healthcare IT News
  • Sunday also showcased global connected health at the International Telemedicine Forum, with speakers from Latin America, India, Australia and China describing how telemedicine is used–from texting to connecting distant clinics with hospitals or patients directly to specialists. It concluded with a signing ceremony for the ATA’s new MoU partners: the eHealth Association of Pakistan, the Telemedicine Society of India, the Armenian Association of Telemedicine, the UK’s Telecare Services Association and the Telemedicine Society of Nepal. ATA’s international delegates display global power of telemedicine
  • A Monday executive roundtable lamented lack of standards for remote monitoring will slow growth, but conceded that ‘medical reform’s’ ACOs, medical networks and documenting better outcomes will help to drive telehealth and telemedicine. Particpants: Louis J. Burns, CEO of Intel-GE Care Innovations: Allen Izadpanah, president and CEO of ViTel Net, Daniel L. Cosentino, MBA, CEO and president of Cardiocom; Jasper zu Putlitz, M.D. of Bosch Healthcare.
  • Robert Bosch Healthcare announced both an improved clinical web application for patient assessment and workflow for Health Buddy and ViTelCare to integrate both platforms, as well as a new advanced weight scale peripheral for Health Buddy. This press release is oddly limited in its information; your editor is angling for more.
  • Short takes from the Tweetstream:

A roundup of press announcements and news coverage prior to the start of ATA 2011. Your editor is Donna Cusano:

  • ATA calling on CMS and Donald Berwick in an open letter to rewrite the ‘restriction-riddled’ Medicare telemedicine statute for ACOs. The restriction on telehealth usage in urban areas alone is absurd. TA 28 April Further commentary in FierceMobileHealthcare.
  • Philips is introducing a cellular modem–confusingly called a ‘cellular accessory’–to connect patient home telehealth data to Philips’ secure server and thereon to a home health provider. Philips is also introducing a steady scale for the home that is designed for frail patients: wireless transmission, measurement up to 440 lbs., integrated handle bars and multilingual audio prompts. Release. Booth #1633.
  • MedApps is interestingly pairing with kiosk designer/builder PhoenixKiosk to create a Personal Health Station, with a blood pressure cuff, weight scale and printer. It is then connected by MedApps’ CloudCare platform and stored to a SmartCard ID or to the patient’s EHR. Release. Booth #1317.
  • Lifecomm–the partnership between Hughes Telematics, Qualcomm and AMAC–just published a study on ‘critical design factors for MPERS’. Older adults want a wearable device that does not ‘stigmatize’ them and integrates into their lives. Release. Booth #1532 (with AMAC)
  • Diabetes monitoring continues to add systems: PositiveID will be demonstrating their iglucose mobile health solution for diabetes management. The device (not yet FDA-approved) wirelessly connects glucometer readings to their database. Booth #1340. Release.
  • Affecting rural telemedicine: Certain to be discussed at ATA is HHS/Health Resources and Services Administration funding of $12 million for up to 40 grants for rural health IT adoption, focusing on EHR meaningful use criteria . iHealthBeat.
  • And as they enter the market with their 510(k) approval in hand, Waldo Health is seeking a VP of Sales. If you are a member of the ATA group on LinkedIn, here is the job posting from COO Alan Weiss. Otherwise, see Alan during ATA at Booth #1125.

Telecare Soapbox: Turning back time with Fast Company and Care Innovations

Wondering what the GE-contributed part of Care Innovations has been up to? This short article in Fast Company online should have been far more informative. Instead, it skids into the journalistic equivalent of a brick wall. Its sole subject: QuietCare–originally developed by another company and acquired by GE. Its tone: recycled from 2006-7. And sadly filled with inaccuracies. It’s making Ed. Donna itching to rant, because she was quite close to QuietCare as it developed from 2006 into early 2009 as part of the founding company, Living Independently Group through the early days of the GE acquisition, and knows better. (more…)

Mobile Healthcare Communications: Case Studies and Roundtables

Presented by the Business Development Institute (BDI)

New York City, Wednesday 19 Jan 2011

Your reporter is Donna Cusano

The content of this semiannual half-day conference on mobile healthcare was oriented primarily for pharmaceutical marketers and communicators. Thus most of the case studies presented were from the pharmaceutical sector, with an emphasis on patient (primary) and physician information delivered via smartphones. Leavening this was a discussion of texting in an adolescent health program here in NYC. A lively tweetstream, projected on a small screen stage right, kept a running commentary and also outside links to videos and other source material.  It is available at #BDI with a transcript of the day’s activity provided by Bridge 6. (Ed. Donna is @deetelecare) 

 

Highlights:
Pfizer and health management.
No exception to the cautious approach pharmaceutical companies tend to (or must) take with social media and partnerships, the heart of Kate Bird’s (Director of Digital Communications Policy) presentation centered on four apps, two outside the US: the partnership with Epocrates enabling direct contact with medical professionals to report adverse events; Smidge in Canada, a behavioral modification app to encourage healthier habits; Protonix mobile co-pay and refills, using designated text codes; and in Hong Kong, Pfizer Nutrition and Yahoo!‘s educational app that lets parents create flash cards for children, using preloaded forms.  What’s surprising is that all these apps are for iPhone only, with no plans to add Android and (ex US) Symbian—but 70% of their searches are from Apple devices (one tweet: Android users don’t get sick)
Ms. Bird is forecasting that apps are becoming saturated anyway, with which many in the audience, including this editor, concurred.) Another surprise: despite quadrupling in traffic recently, Pfizer’s website has only just been redone for mobile, which will enable the current 1% of their website impressions to grow and to benefit on what they have found is a lower cost per click cost. (Memo to Pfizer: your patients are not only using Android phones, but many will be buying tablets (and not just iPads.)

 

Joe Grigsby (Director, Emerging Media) from agency VML presented the case history on Text4Baby, the nearly two year old prenatal health reminder SMS for mothers [TA 8 Nov] which is 6 million texts to date; with 100,000+ users T4B is projecting an eventual 1 million.  Among future professionals, 25% of nursing students use iPhones, 70% of medical students have iPhone/iPod. But his points were strategic, reminding the audience that even though mobile is the ‘new norm’ for a younger age group, it doesn’t change marketing fundamentals and the need to develop a marketing strategy.  If anything, mobile has enhanced consumer control (as long as their information is secure). Smart marketers have to think even more about the end user and their individual goals as shaping the value proposition, not what app to make; what they are doing and how to add value. (Slideshow available at Slideshare)

 

Helping ACCU-CHECK diabetes monitor users better understand their condition and how to manage it is Roche Diabetes Care’s ‘Glucose Buddies’ iPhone app (again, no mention of Android). This free app also gathers general demographic information for Roche which is a secondary business goal, in addition to patient education. This information sparked a Twitter commentary on tradeoffs on privacy for ‘value’ although the data is ‘de-identified’.  The lack of a Spanish-language version that would be targeted to Hispanics who have, as a population, an above-average incidence of diabetes, also prompted a few choice tweets. Presented by Todd Siesky, PR Manager, Roche Diabetes Care.

 

Monique Levy’s review of Manhattan Research’s recent mobile-related studies touched on some points already made on Telecare Aware. Key highlights:

Physicians and mobile
* Doctors are abandoning the mainstay BlackBerry for the iPhone, with Android down the list (for now)
* MR projects that currently 72% of physicians have smartphones, projecting that 81% of doctors will have a smartphone by end of year, accelerating their year-ago projection by a year. [TA 3 Mar]   25% will have iPads and/or tablets (note the Dell Streak is targeting healthcare enterprise: TA 15 Sept ).
* Health info outpoints health tools. Visiting websites is as common as using apps like Epocrates, Medscape Mobile and Skyscape—doctors are seeking information (note to pharma companies, publications and references—time to get mobile versions of your websites)
* 65% of physicians use smartphones to check e-mails, but 41% are using mobile Websites and 38% apps.
* The greatest uses of smartphones (@50% in descending order): drug reference databases, clinical/medical references, reading medical journals, treatment guidelines, prescription dosage calculator)
* Remote patient monitoring is underdeveloped at 10%–same as writing medical notes

Consumers and mobile
* Again, health info outpoints health ‘tools’ or apps
* And it won’t come from pharma companies: 71% of those age 35+ are “not interested” in mobile services from a pharma company. (What will pharma do to win them over?)

 

Leaving the lofty heights of pharma-land for the streets of the South Bronx and East Harlem, Dr. Katherine Malbon of the Mount Sinai Adolescent Health Center (MSAHC) shared how her idea to connect young patients with their ‘health home’ at MSAHC via text messaging and social media turned into a six-month successful program, ‘Text in the City’.  Teens opt-in for information, individual answers to their questions (within 24 hours, birth control reminders (most requested) and weekly ‘HealthBytes’ of advice.  Texting and often unlimited plans are ubiquitous (95%) in this population and age group—an amusing example was a teenaged girl texting non-stop as she received a physical exam! But privacy is a concern—users are reminded to delete their perhaps sensitive texts. Dr. Malbon’s passion is clearly serving teens—trained as a paediatrician and working in several Central London hospitals, she moved to the US as adolescent medicine is not a recognized sub-specialty in the UK.

 

Rounding out the conference was more on marketing and communications from Porter Novelli’s EVP Social Media, John Havens.  One memorable quote:  “If you want to speak doctor – speak mobile.” With the PwC findings of 56% of Americans liking the idea of remote healthcare and 41% via mobile phone—he focused on the less conventional as ‘pointers to the future’, such as earplugs that gauge your eating and wirelessly report activity (U. of WA), the Kaiser WeightMate app acting like a Chinese mother after you brought home a B, Frontline SMS: Medic (now Medic Mobile) in developing countries and goggles that prompt with speech and images. “Why is mobile so important for healthcare? Because it saves lives.”  Just a reminder why we are in the field…and that mobile technology is changing so quickly that unless we are otherwise funded (non-profit) developers and marketers need to focus on business case, goals and usage/ROI.

Many thanks to Maria Feola and Steve Etzler of BDI and Mario Nacinovich of AXON plus the Journal of Communication in Healthcare.

Robotic roundup at CES 2011

Perhaps overshadowed by ten jillion tablets, 3D TVs and Motorola’s Atrix, robots were also at CES, many of course from Japan and in their own TechZone. Many had something to do with cleaning, but these had applicability to healthcare: Israeli company DreamBots with their WheeMe robotic masseur that won’t fall off your back–at $69 may be next Christmas’ hit item; iRobot’s AVA self-navigating, tablet-controlled droid; Pleo RB, the cuddly dinosaur with a personality that evolves with human interaction and even knows to shiver in a cold room; the Anybot telepresence droid with a laser pointer (keep away from airports); Soft Robots from Quality of Life Technology Center to assist with activities of daily living such as feeding, dressing and transfer; and Autom, the googly-eyed robot diet mentor who tells you if you’ve been dieting or splurging. PARO, our cuddly and vocal harp seal, was also there but wandered off from this roundup. TechRepublic rounds up the robots for you.

CES 2011 telehealth highlights

Rounding up the CES news on telehealth (updated 11 Jan):

  • Mobihealthnews has a preview slideshow of what they rated as the most interesting telehealth-related items at CES.  Our top picks from theirs:
    1. the long-awaited Lifecomm mPERS from Hughes Telematics with minority partners Qualcomm and AMAC. Available end of 2011. Release. Website.
    2. AliveCor’s iPhone ECG: a case for the iPhone 4 that pairs with an app to create a clinical-quality ECG. This is probably a 2012 Game Changer (see below) if it gains FDA and CE approvals–and keeps its pricing around the rumored sub-$100 price point. Check out MedGadget and the Dr. David Albert video.
    3. iHealth Lab’s Blood Pressure Monitoring system for the iPhone (iPad and iPod): a dock and cuff combination, in release shortly
    4. Withings’ latest: the Blood Pressure Monitor cuff with a transmitter at the end that connects to an iPhone, iPad or iPod and feeds information into respective apps. This also made CNN’s top CES devices .
    5. The Ideal Life Health Tablet:  a proprietary device that claims it is ‘the first tablet that automatically synchronizes with data systems used by providers, patients or caregivers.’  Photo not available. Release.
    6. Diabetes monitoring remains hot; perhaps because of this, the devices and apps are beginning to resemble others plus variations. Consumer Cellular, a wireless provider to AARP members, is adding lifestyle apps, including diabetes monitoring. along with a GPS tracker. Release. Telcare displayed its 3GM blood glucose meter, still in prototype and with no FDA approvals, at Qualcomm’s exhibit as it utilizes Qualcomm’s M2M ‘Internet of Everything Module.’ Release.
  • The Digital Health Summit wound up its Friday conference with a panel of ‘The Game Changers of 2011’: PhiloMetron (a biotech incubator most recently known for a smart patch for diet tracking), Proteus Biomedical (smart pills), Healthsense (sensor-based telecare and security) and RSLSteeper’s BeBionic amazing prosthetic hand [TA 24 June].  [Disclosure: Telecare Aware was a media partner of the 2011 Digital Health Summit]
  • Acknowledging that not all older people want or need a high perceived level of tech in the home, Independa launched its phone-based Smart Reminders system. The family member/caregiver calendars events, appointments, activities and medication reminders online–the older person receives telephone reminders that must be confirmed. Free trial offer for six weeks, $19.95/month thereafter. Release.
  • AgeTek–the Aging Technology Alliance–had its own booth in the SilversSummit/Digital Health Summit area, plus its first annual AgeTek member meeting. Peter Radsliff, Presto CEO and AgeTek Chair, reported to this editor [Donna] tremendous interest: AgeTek is up to 47 paid members, including new members AARP, Flipper Remote, Telekin and distribution players Home Controls and HealthTech Marketing Group; 10 additional probable from interested companies. Traffic in the area (North Hall) was high, based on a live video feed I saw on Thursday. Peter also reported ‘fantastic ideas from members for 2011 initiatives’ plus an all new website to launch in a few weeks–now designed as a portal for consumers to find products and services for aging in place from AgeTek members.
  • BBC video report (2min) on the Sonamba device. Previous ZDNet report. [Steve] This table-top ‘wellbeing monitor’ from pomdevices was displayed at the i-Stage TechZone. It is designed for an older person who needs some assistance and social connectivity. It is M2M cellular and combines basicsonamba motion/sound sensors (wellbeing monitoring), med reminders, a PERS, text messaging, games and a digital photo frame (!) with an iPhone app for caregiver monitoring and adjustment. Not inexpensive (‘pure’ unit cost is $549.99 direct from the manufacturer–no retail announced yet) but with plans moderating the actual cost including monthly data charges ranging from $39-$69, it becomes 1) comparable to PERS and other devices and 2) roughly comparable to a higher end cell phone. Company is based in North Carolina, founder ex-Intel and eFusion. [Donna] Updated 11 Jan: Popular Science included Sonamba in their ‘Best of CES 2011: Products of the Future.’ Also included was the Motorola Atrix 4G [TA 7 Jan]